Healthcare Provider Details

I. General information

NPI: 1780578187
Provider Name (Legal Business Name): FRANCISCAN BRETHREN OF ST. PHILIP INC LITTLE SISTERS OF ST. F
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17465 ELTHAM ROAD
LANEXA VA
23089
US

IV. Provider business mailing address

P.O. BOX 1356 WILLIAMSBURG VA
WILLIAMSBURG VA
23187-1356
US

V. Phone/Fax

Practice location:
  • Phone: 804-843-9013
  • Fax: 804-843-9016
Mailing address:
  • Phone: 757-256-6937
  • Fax: 757-208-0348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARGARET WAMALWA WALUBUKA
Title or Position: VICE PRESIDENT
Credential: ADMINISTRATOR/VP
Phone: 757-256-6937